Westerlund M
Central Unit of Child Health Care, Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden.
Scand J Caring Sci. 2001;15(3):222-7. doi: 10.1046/j.1471-6712.2001.00016.x.
This study, which was carried out under routine conditions, evaluates the predictability of a global rating of children's speaking manner made by Child Health Centre nurses. The global rating was added to a formalized screening of 3-yr olds, which intended to identify severely language disabled children. This screening procedure is used in several Swedish counties and the participation rate is nearly 100%. The main questions of the study are: (i) can a global rating of speech ability in children, who have passed the 3-yr screening, predict the outcome of a new population screening 1 yr later? and if so (ii) what is the most efficient cut-off point?
The global ratings of the 3-yr olds were made using a 100 mm visual analogue scale (VAS). At the age of 4 yrs, 2065 globally rated children with no objections from the 3-yr screening participated in a second, well-established assessment. The purpose of this second screening was to identify not only severe but also moderate disability.
The mean VAS value of the global ratings was 62 mm. One-third of the ratings fell on the lower half of the scale. With a cut-off level set at < or =50 mm on the VAS two newly-identified, severely disabled children and 74% of the moderately disabled 4-yr olds were identified.
The results suggest that the global rating in connection to the 3-yr screening would serve as a useful tool for selective screening of 4-yr olds, and thus, reduce the work load.
本研究在常规条件下开展，评估儿童健康中心护士对儿童说话方式进行整体评分的可预测性。该整体评分被纳入对3岁儿童的规范化筛查中，旨在识别严重语言障碍儿童。这种筛查程序在瑞典的几个县使用，参与率接近100%。本研究的主要问题是：（i）通过3岁筛查的儿童的语言能力整体评分能否预测1年后新的人群筛查结果？如果可以，那么（ii）最有效的临界点是什么？
对3岁儿童的整体评分采用100毫米视觉模拟量表（VAS）。在4岁时，2065名在3岁筛查中无异议且有整体评分的儿童参与了第二次成熟的评估。第二次筛查的目的不仅是识别严重残疾，还包括中度残疾。
整体评分的平均VAS值为62毫米。三分之一的评分落在量表的下半部分。将VAS的临界点设定为≤50毫米时，识别出了2名新发现的严重残疾儿童以及74%的中度残疾4岁儿童。
结果表明，与3岁筛查相关的整体评分可作为对4岁儿童进行选择性筛查的有用工具，从而减轻工作量。
